Part of being a woman assigned at birth can mean there’s always something worrying you. Feeling super emotional? Your period might be on the way! If your period is a little late, you’re probably already obsessing over whether you’re pregnant (even though the last time you had sex was years ago)! And if you experience any vaginal changes? You guessed it – you’re worried you might have contracted an STI. While these are all valid concerns, we’re here to break down the most common STI symptoms and what they mean. The good news is that there are things you can do to protect yourself from infection and treatments are available. But arming yourself with knowledge about STIs can go a long way in keeping you safe.
Why is knowing STI symptoms important?
The more you know about STI symptoms, the more you can protect yourself. And, according to the National Institute for Communicable Diseases (NICD), “in 2017, there were an estimated 2.3 million new cases of gonorrhoea, 1.9 million new chlamydia cases and 23 175 new syphilis cases among women aged between 15 and 49.” The website continues to note that “these high numbers of STI cases in South Africa have partly been due to inadequate prevention and treatment gaps.” Indeed.
Um, what’s the difference between an STD and an STI?
Excellent question! An STI (sexually transmitted infection) “refers to an infection that is transmitted through sexual activity,” explains Dr Mpume Zenda, an obstetrician, gynaecologist and sexologist. “A sexually transmitted disease (STD) refers to a specific condition or illness that has developed as a result of a sexually transmitted infection.” Noted!
STIs include curable infections like chlamydia, gonorrhoea, syphilis, and trichomonas. An STI could also be an incurable but treatable condition, like herpes simplex virus, HIV and human papillomavirus (HPV), Dr Zenda explains.
READ MORE: What’s The Difference Between STDs And STIs?
How treatable are STIs?
Per Dr Zenda, it depends on the infection. Chlamydia, gonorrhoea, syphilis, and trichomonas can be cured with antibiotics. Incurable STIs like herpes, HIV and HPV can be treated with medication and “effective treatment with antiretroviral medication suppresses viral replication,” Dr Zenda notes.
Can you have an STI but no symptoms?
Yes, you can. “Some STIs cause no symptoms or only mild symptoms,” says Dr Zenda. But, importantly, even if you exhibit no symptoms, you can still pass the infection on to someone else. For this reason, “if you start a new sexual relationship, get tested for STIs,” advises Dr Jireh Serfontein, clinical head of My Sexual Health Pretoria. Also, “the risk of contracting HIV is much higher if you have an STI, so get tested and treated,” she says.
How long does it take for an STI to ‘appear’?
“Every STI has its own incubation period,” explains Dr Zenda. “For some, the body begins to produce antibodies and symptoms in as little as a few days.” Below are the typical timelines for when STI symptoms appear. But know that for some people, it can take weeks or months for an infection to manifest.
- Gonorrhoea: 1 – 7 days
- Chlamydia: 7 – 21 days
- Genital and oral herpes: 2 – 12 days
- HIV: 2 – 4 weeks
- HPV: 1 month – 10 years
- Syphilis: 3 weeks – 20 years
Because STI symptoms can take long to show up, it’s important to get tested. It’s also why STI tests use antibodies to detect infection and not symptoms, explains Dr Zenda.
READ MORE: 8 Things You’ve Heard About STDs That Are Totally Untrue
What happens if an STI never gets treated?
Because STIs affect the reproductive tract, explains Dr Zenda, the risk of untreated STIs is that they can affect your reproductive organ. “Pelvic inflammatory disease (PID), caused by infection of the uterus, fallopian tubes and ovaries can lead to infertility,” she says. Added to that, here are other complications from untreated STIs.
Untreated STIs can affect your pregnancy
“Pregnant people with untreated chlamydia, for example, are at a greater risk of miscarriage, premature birth, and stillbirth,” explains Dr Zenda.
Untreated STIs can infect a baby
Per the National Institutes of Health, a sexually transmitted infection can cross into the placenta and infect the baby in the womb. “High HIV viral loads increase the risk of transmitting the virus to the child during delivery or breastfeeding,” explains Dr Zenda. “Gonorrhoea can be passed from parent to child during vaginal delivery, causing a potentially severe eye infection. Syphilis and herpes can be potentially fatal in a newborn.”
READ MORE: How Long Does A UTI Last And Can It Go Away On Its Own?
STI symptoms and what they mean
Burning sensation when peeing
While your first instinct could be to think that a burning sensation points to an STI symptom, Dr Zenda says it’s more likely to be a UTI (or urinary tract infection). But yes, in some cases, an STI could cause the burning sensation because of cross-infection, she says. “The pain comes from inflammation in your urinary tract. Bacteria can cling to the lining (mucus membranes) of the urethra, which is the tube urine comes out of, causing inflammation.”
Per Dr Serfontein, “STIs that cause burning can include herpes, chlamydia, gonorrhoea, trichomoniasis, ureaplasma or mycoplasma.”
Unusual discharge
While discharge can change in quality throughout your menstrual cycle, there are times when your discharge signals an STI. “Changes in the colour, texture, smell or amount of your usual vaginal discharge may mean there is a problem,” says Dr Zenda. “Vaginal discharge that is chunky, foamy or accompanied by itching and changes in colour may mean you have an infection.”
But! Not all unusual discharge means you have an STI. In some cases, a change in your PH levels, like with a yeast infection or bacterial vaginosis, could result in unusual discharge. In any case, those require treatment, so see your doc.
READ MORE: At-Home Test Kits: From Ovulation To STDs, Here’s How To Get Results At Home
Abnormal bleeding
Two periods in one month? What fresh hell? Take heart: abnormal bleeding could be caused by things other than an STI. It could be a side-effect of starting a new contraception method, but still, it’s very important to see your doctor to rule out any other serious causes, “especially when the bleeding is heavy, post-intercourse, or associated with pain and offensive odour,” says Dr Zenda. Other causes of abnormal bleeding include:
- Cervicitis (inflammation)
- Vaginal tears (especially from poor lubrication)
- Polyps or fibroids
- Pregnancy-related (from ectopic pregnancy or miscarriage )
- Infections including, STIs
- Cancer (cervical, vaginal or endometrial)
If you’re experiencing abnormal vaginal bleeding, see your doc, stat.
Itchy vaginal sensation
Unless you’ve just shaved down there, the itching sensation is not normal, says Dr Serfontein. “It can mean that there is irritation of the skin and mucous membranes in the genital region,” she explains.
However, it might not be an STI symptom, either. “A yeast infection (thrush) caused by candida typically presents with an itching or burning sensation,” explains Dr Serfontein. Another thing that could cause that itchy sensation? Dermatological conditions like lichen sclerosis. “Some women might experience itching or burning due to side effects of a contraceptive pill as well,” adds Dr Serfontein.
But if your itching is a sign of an STI, there will be accompanying symptoms, says Dr Serfontein. These could include abnormal vaginal discharge. “But it is important to note that you can have those infections without any symptoms at all, that is why it is so important to get regular STI testing,” says Dr Serfontein.
Painful sex
Again, there are other reasons sex could become painful other than an STI. “It is important to determine when the pain started, what type of pain you have and where exactly you experience the pain,” says Dr Serfontein.
For one, painful sex could be a result of vaginismus. “This is caused by the muscles around the vagina that are in spasm and will result in penetration being painful,” explains Dr Serfontein. In this instance, even using a tampon could be too painful.
If your pain is deep and located in the lower abdominal area, it could be caused by a cyst or pelvic inflammatory disease (PID). “This usually occurs when sexually transmitted bacteria spread from the vagina to the womb (uterus), fallopian tubes or ovaries,” says Dr Serfontein.
“It is not that easy to distinguish between sex-related pain and pain caused by an STI,” Dr Serfontein notes. But there are STIs that can cause pain during sex, like chlamydia and gonorrhoea, which causes vaginal irritation that can lead to pain. “Genital herpes can cause blister or sores in the genitals which can also lead to painful sex,” says Dr Serfontein.
In any case, pain during sex is not normal, she says, so go and see your doc if this happens to you.
READ MORE: Why Am I Bleeding During Sex? Gynaecologists Explain Common Reasons And Treatments
Bumps on the vagina
Bumps could be caused by infection or benign conditions like ingrown hairs, says Dr Serfontein. Infections that could result in bumps include:
- Genital warts: “These lesions will be wart-like in appearance and are caused by the human papillomavirus (HPV),” says Dr Serfontein.
- Molluscum: “These lesions are flesh-coloured, round and painless bumps. This is caused by a viral infection called molluscum contagiosum.”
- Genital herpes: “These lesions are blisters and are caused by the herpes virus. It would typically be accompanied by pain in the genital area.”
Pelvic pain
“Pain means that there is a problem, it is important to see a doctor,” says Dr Serfontein. “Pelvic pain could be because of pelvic inflammatory disease (PID). This usually occurs when sexually transmitted bacteria spread from the vagina to the womb (uterus), fallopian tubes or ovaries.” You might also experience abnormal discharge, says Dr Serfontein.
But aside from being an STI symptom, pelvic pain can also be caused by these:
- Bladder infection (UTI) – “A UTI might also cause burning urine or frequent urination,” says Dr Serfontein.
- Cyst on the ovaries
- Problems with the gastrointestinal system
- Referred pain from other regions
If you’re experiencing any of these unusual symptoms, it’s always a good idea to get things checked out by a doctor.
